Kevin N Kopack, MSPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

NJQA03353 Issued in NJ

Practice address

297 Passaic Ave Ste 3
Fairfield, NJ 07004-2548

Phone

(973) 227-4280

Fax

(973) 227-4210

NPI assigned

Jan 15, 2007

Last updated

Jun 28, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kevin Norman KopackGroup PAC ID 6204001043, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kevin Norman Kopack

  • Physical Therapy Clinic/Center
  • Fairfield, NJ
  • NPI 1740577964
  Medicare reassignment Care Compare group NPD Authorized official
• Fairfield Physical Therapy Center LLC

  • Physical Therapist
  • Fairfield, NJ
  • NPI 1851436729
  NPD (past)
• Jag-One Physical Therapy, LLC

  • Physical Therapist
  • West Orange, NJ
  • NPI 1518017144
  NPD (past)
• Peter Barnett & Howard J Phillips

  dba Suburban Therapy Center

  • Physical Therapist
  • Cedar Grove, NJ
  • NPI 1376523605
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751068800000",
    "number": "1003967381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CUPSAW AVE",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "074562919",
            "telephone_number": "973-962-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 PASSAIC AVE STE 3",
            "city": "FAIRFIELD",
            "state": "NJ",
            "postal_code": "070042548",
            "telephone_number": "973-227-4280",
            "fax_number": "973-227-4210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Greenwood Lake Tpke",
            "address_purpose": "LOCATION",
            "city": "Ringwood",
            "state": "NJ",
            "postal_code": "074561500",
            "country_code": "US",
            "telephone_number": "973-616-0442",
            "fax_number": "973-616-0442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOPACK",
        "first_name": "KEVIN",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2025-06-28",
        "certification_date": "2025-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "NJ40QA00335300",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "NJQA03353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirti J.Tolia D.D.S.,P.a.
• Earl Lloyd Klay, RPH
• Jing-Yang Elton Ko, D.D.S.
• Jung-Soo Koh
• Jeffrey Michael Kopack, PT, DPT
• Maria Koutsoumbis, MS, CCC-SLP
• Jennifer Kit Kreiger
• Kristen Hanisch LLC (Hanisch Counseling Services)
• Lisa Marie Krivis, DPT
• Dena L Lacara, D.O.

• Physical Therapist in Fairfield, NJ
• Providers in Fairfield, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.